{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T10:38:30Z","timestamp":1778755110405,"version":"3.51.4"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007219","name":"Natural Science Foundation of Shanghai","doi-asserted-by":"publisher","award":["17ZR1406000"],"award-info":[{"award-number":["17ZR1406000"]}],"id":[{"id":"10.13039\/100007219","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Primary vulvar melanoma was an aggressive and poorly understood gynecological tumor. Unlike cutaneous melanoma, the incidence of vulvar melanoma was low but the survival was poor. There were no standard staging system and no census on treatment strategies of vulvar melanoma. Therefore, we aimed to conduct and validate a comprehensive prognostic model for predicting overall survival of vulvar melanoma and provide guidance for clinical management.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients diagnosed with vulvar melanoma between year 2004 and 2015 from Surveillance, Epidemiology, and End Result (SEER) database were randomized to training cohort and validation cohort. Multivariate survival analysis was performed to screen for independent factors of survival. A nomogram was established to predict overall survival of vulvar melanoma. Receiver operating characteristic curve and calibration plot were performed to verify the discrimination and accuracy of the model. The decision curve analysis was performed to verify the clinical applicability of the model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Total 737 patients with vulvar melanoma were randomized to the training cohort (n\u00a0=\u00a0517) and the validation cohort (n\u00a0=\u00a0220). Nomogram including age, race, tumor site, depth of tumor invasion, lymph node status, distant metastasis, tumor size, surgery, chemotherapy and radiotherapy was established and validated. The c-indexes for SEER stage, American Joint Committee on Cancer stage and this model were 0.561, 0.635 and 0.826, respectively. The high-risk group scored by this model had worse survival than the low-risk group (P\u00a0&amp;lt;\u00a00.001). Decision curve analysis revealed this model was superior in predicting survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our model was deemed to be a useful tool for predicting overall survival of vulvar melanoma with good discrimination and clinical applicability. We hoped this model would assist gynecologists in clinical decision and management of patients diagnosed with vulvar melanoma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jjco\/hyaa137","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T11:29:33Z","timestamp":1594380573000},"page":"1386-1394","source":"Crossref","is-referenced-by-count":10,"title":["Construction and validation of a prognostic nomogram for primary vulvar melanoma: a SEER population-based study"],"prefix":"10.1093","volume":"50","author":[{"given":"Hongyu","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuan","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"},{"name":"Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoran","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"},{"name":"Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihua","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"},{"name":"Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,8]]},"reference":[{"key":"2020121604535642900_ref1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.ygyno.2018.04.562","article-title":"Melanoma of the lower genital tract: prognostic factors and treatment modalities","volume":"150","author":"Gadducci","year":"2018","journal-title":"Gynecol Oncol"},{"key":"2020121604535642900_ref2","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s11912-012-0244-x","article-title":"Mucosal melanoma: pathogenesis, clinical behavior, and management","volume":"14","author":"Postow","year":"2012","journal-title":"Curr Oncol Rep"},{"key":"2020121604535642900_ref3","doi-asserted-by":"crossref","first-page":"2961","DOI":"10.1002\/ijc.28625","article-title":"Epidemiology and survival outcomes of ocular and mucosal melanomas: a population-based analysis","volume":"134","author":"Bishop","year":"2014","journal-title":"Int J Cancer"},{"key":"2020121604535642900_ref4","doi-asserted-by":"crossref","first-page":"166 e7","DOI":"10.1016\/j.urolonc.2015.11.009","article-title":"Primary genitourinary melanoma: epidemiology and disease-specific survival in a large population-based cohort","volume":"34","author":"Sanchez","year":"2016","journal-title":"Urol Oncol"},{"key":"2020121604535642900_ref5","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jaad.2015.10.015","article-title":"Epidemiology of genitourinary melanoma in the United States: 1992 through 2012","volume":"75","author":"Vyas","year":"2016","journal-title":"J Am Acad Dermatol"},{"key":"2020121604535642900_ref6","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1002\/cncr.30473","article-title":"Vulvar and vaginal melanoma: a unique subclass of mucosal melanoma based on a comprehensive molecular analysis of 51 cases compared with 2253 cases of nongynecologic melanoma","volume":"123","author":"Hou","year":"2017","journal-title":"Cancer"},{"key":"2020121604535642900_ref7","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3109\/0284186X.2010.535846","article-title":"Spatial density of primary malignant melanoma in sun-shielded body sites: a potential guide to melanoma genesis","volume":"50","author":"Ragnarsson-Olding","year":"2011","journal-title":"Acta Oncol"},{"key":"2020121604535642900_ref8","article-title":"Malignant melanoma of the vulva and vagina: a US population-based study of 1863 patients","author":"Wohlmuth","year":"2019","journal-title":"Am J Clin Dermatol"},{"key":"2020121604535642900_ref9","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.ygyno.2016.04.021","article-title":"Rare vulvar malignancies; incidence, treatment and survival in the Netherlands","volume":"142","author":"Pleunis","year":"2016","journal-title":"Gynecol Oncol"},{"key":"2020121604535642900_ref10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ctrv.2018.12.005","article-title":"Vulvar malignant melanoma: pathogenesis, clinical behaviour and management: review of the literature","volume":"73","author":"Boer","year":"2019","journal-title":"Cancer Treat Rev"},{"key":"2020121604535642900_ref11","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1097\/IGC.0000000000000768","article-title":"Prognostic factors of recurrence and survival in vulvar melanoma: subgroup analysis of the VULvar CANcer study","volume":"26","author":"Iacoponi","year":"2016","journal-title":"Int J Gynecol Cancer"},{"key":"2020121604535642900_ref12","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1158\/1078-0432.CCR-16-2126","article-title":"Tumor thickness and mitotic rate robustly predict melanoma-specific survival in patients with primary vulvar melanoma: a retrospective review of 100 cases","volume":"23","author":"Nagarajan","year":"2017","journal-title":"Clin Cancer Res"},{"key":"2020121604535642900_ref13","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.ygyno.2011.04.007","article-title":"Malignant melanoma of the vulva: an extension of cutaneous melanoma?","volume":"122","author":"Moxley","year":"2011","journal-title":"Gynecol Oncol"},{"key":"2020121604535642900_ref14","doi-asserted-by":"crossref","first-page":"e94","DOI":"10.1097\/PAS.0000000000000749","article-title":"The Surveillance, Epidemiology, and End Results (SEER) program and pathology: toward strengthening the critical relationship","volume":"40","author":"Duggan","year":"2016","journal-title":"Am J Surg Pathol"},{"key":"2020121604535642900_ref15","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1007\/s00404-016-4144-4","article-title":"Genital melanoma: prognosis factors and treatment modality","volume":"294","author":"Ferraioli","year":"2016","journal-title":"Arch Gynecol Obstet"},{"key":"2020121604535642900_ref16","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1097\/IGC.0000000000000198","article-title":"Gynecologic Cancer InterGroup (GCIG) consensus review for vulvovaginal melanomas","volume":"24","author":"Leitao","year":"2014","journal-title":"Int J Gynecol Cancer"},{"key":"2020121604535642900_ref17","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/CMR.0b013e32833684e8","article-title":"Population-based incidence of vulvar and vaginal melanoma in various races and ethnic groups with comparisons to other site-specific melanomas","volume":"20","author":"Hu","year":"2010","journal-title":"Melanoma Res"},{"key":"2020121604535642900_ref18","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.ygyno.2017.08.023","article-title":"Gynecologic melanomas: a clinicopathologic and molecular analysis","volume":"147","author":"Udager","year":"2017","journal-title":"Gynecol Oncol"},{"key":"2020121604535642900_ref19","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1097\/LGT.0000000000000204","article-title":"Surgical management and prognostic factors of Vulvovaginal melanoma","volume":"20","author":"Ditto","year":"2016","journal-title":"J Low Genit Tract Dis"},{"key":"2020121604535642900_ref20","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S1470-2045(08)70254-7","article-title":"Management of primary melanoma of the female urogenital tract","volume":"9","author":"Piura","year":"2008","journal-title":"Lancet Oncol"},{"key":"2020121604535642900_ref21","doi-asserted-by":"crossref","first-page":"e277","DOI":"10.14694\/EdBook_AM.2014.34.e277","article-title":"Management of vulvar and vaginal melanomas: current and future strategies","author":"Leitao","year":"2014","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"2020121604535642900_ref22","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1097\/01.AOG.0000271209.67461.91","article-title":"Vulvar melanoma: a multivariable analysis of 644 patients","volume":"110","author":"Sugiyama","year":"2007","journal-title":"Obstet Gynecol"},{"key":"2020121604535642900_ref23","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s10147-017-1193-z","article-title":"Japan Society of Gynecologic Oncology guidelines 2015 for the treatment of vulvar cancer and vaginal cancer","volume":"23","author":"Saito","year":"2018","journal-title":"Int J Clin Oncol"},{"key":"2020121604535642900_ref24","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s00404-009-1134-9","article-title":"Conservative surgical treatment for early-stage vulvar malignant melanoma","volume":"281","author":"Nasu","year":"2010","journal-title":"Arch Gynecol Obstet"},{"key":"2020121604535642900_ref25","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/CCO.0000000000000104","article-title":"Management of melanomas of the gynaecological tract","volume":"26","author":"Nobbenhuis","year":"2014","journal-title":"Curr Opin Oncol"},{"key":"2020121604535642900_ref26","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1093\/jrr\/rrt120","article-title":"Clinical trial of carbon ion radiotherapy for gynecological melanoma","volume":"55","author":"Karasawa","year":"2014","journal-title":"J Radiat Res"},{"key":"2020121604535642900_ref27","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.ygyno.2013.02.028","article-title":"Vulvar and vaginal melanoma: case series and review of current management options including neoadjuvant chemotherapy","volume":"129","author":"Janco","year":"2013","journal-title":"Gynecol Oncol"},{"key":"2020121604535642900_ref28","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1097\/00008390-200412000-00012","article-title":"Biochemotherapy in patients with advanced vulvovaginal mucosal melanoma","volume":"14","author":"Harting","year":"2004","journal-title":"Melanoma Res"}],"container-title":["Japanese Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jjco\/article-pdf\/50\/12\/1386\/34925261\/hyaa137.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jjco\/article-pdf\/50\/12\/1386\/34925261\/hyaa137.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T11:31:00Z","timestamp":1608118260000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jjco\/article\/50\/12\/1386\/5885443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,8]]},"references-count":28,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,8,8]]},"published-print":{"date-parts":[[2020,12,16]]}},"URL":"https:\/\/doi.org\/10.1093\/jjco\/hyaa137","relation":{},"ISSN":["1465-3621"],"issn-type":[{"value":"1465-3621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,8,8]]}}}